Photoshop软件联合超声内镜在胃间质瘤不同侵袭危险性分级中的应用*

Photoshop combined with Endoscopic Ultrasonography in grading invasive risk of gastric stromal tumors*

摘要:

目的 探讨Photoshop软件联合超声内镜（EUS）对胃间质瘤（GISTs）不同侵袭危险性分级的应用价值。方法 选取经病理及免疫组化确诊的GISTs患者97例，根据其肿瘤大小、核分裂象及肿瘤破溃分为极低危组、低危组、中危组以及高危组，利用Photoshop软件分别测定各组病灶EUS图像的灰度平均值（代表回声强度）及灰度标准偏差平均值（代表回声均匀度），行统计学分析，寻找各组差异。结果 不同侵袭危险性GISTs EUS图像有时肉眼难以鉴别；极低危、低危、中危及高危组EUS图像的灰度平均值（代表回声强度）分别为（56.54±6.10）、（59.20±7.51）、（77.77±10.90）和（83.43±12.47），极低危组与低危组比较、中危组与高危组比较，差异无统计学意义（P >0.05），其余各组两两比较，差异均有统计学意义（P <0.05）；极低危、低危、中危及高危组的灰度标准偏差平均值（代表回声均匀度）分别为（8.46±2.59）、（12.57±5.89）、（12.84±4.15）、（16.69±4.69），除低危组与中危组比较差异无统计学意义外（P >0.05），其余各组两两比较，差异均有统计学意义（P <0.05）。结论 GISTs侵袭危险性越高，EUS回声强度总体上越高，而回声均匀性总体上越差，EUS联合Photoshop软件分析EUS图像的灰度平均值和灰度标准偏差可在术前辅助判断GISTs侵袭危险性。

Abstract:

Objective To investigate the application value of Photoshop in grading invasive risk of gastric stromal tumors (GSTs). Methods EUS image of 97 cases of GSTs confirmed by pathological and immunohistochemical examination were collected. GSTs were divided into four groups (very low risk, low risk, intermediate risk, high risk) by tumor size, mitotic count and rupture of tumor. Mean gray value (intensity of echo) and gray value standard deviation (uniformity of echo) of EUS images of the lesions were determined by Photoshop and then the differences of each group were found by statistical analysis. Results It is difficult to differentiate EUS images of GSTs from each group by visual observation. The mean gray value of EUS image of very low risk group, low risk group, intermediate risk group and high risk group of GSTs respectively were (56.54 ± 6.10), (59.20 ± 7.51), (77.77 ± 10.90) and (83.43 ± 12.47). There was no significant difference between very low risk group and low risk group (P > 0.05). There was no significant difference between intermediate risk group and high risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). The mean gray value standard deviation of EUS image of very low risk group, low risk group, intermediate risk group and high risk group of GSTs respectively were (8.46 ± 2.59), (12.57 ± 5.89), (12.84 ± 4.15) and (16.69 ± 4.69). There was no significant difference between low risk group and intermediate risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). Conclusions The higher risk of GSTs, the higher of echo intensity and the worse of echo uniformity under EUS. Photoshop combined with EUS is helpful for differentiating different risk of GSTs by analyzing mean gray value and gray value standard deviation of the lesions.